My 3 mo X ray - Discs tilted all over the place

[steve55]

Saw Dr Delamarter yesterday. His first comment to me was "well, you certainly get around". LOL. I guess he said that because I have been to the very top doctors thus far (Dr Peloza, TBI, and of course Dr B, then Dr Mignucci whom he knows). As it turns out, he has agreed with Dr Bertagnoli that Dr Mignucci's reccomendation of removing the ADR's and doing a corpedectemy is extreme and completely unnecessary. Dr Delamarter said he is familar with this doctor (Dr Luis Mignucci), and said that this doctor has a bias against keeled ADR's and often recommends their removal to patients who have them. And of course, Dr Mignucci is associated with the Bryan disc and does not support the Prodisc design due to the keel.

Secondly, Dr Delamarter alleviated my concern from the two other doctor reports that seemed to state that the top c4/5 ADR might appear to have no movement. Dr Delamarter took a marker pen and ruler and measured out the distances between my vertebrae in the flexion extended positions and measured them with his ruler. Once he showed me this, it became abundantly clear to me that I do have some movement, though limited, at that location.Dr Delamarter said that the normal ADR movement range is 4-7 degrees, and I have about 2 degrees of movement. He said that my 2 degrees of movement is still significantly beneficial in preventing adjacent level stresses and degeneration. He stated that any movement at all is beneficial compared to no movement that one gets with a fusion. One thing I forgot to ask is why he thinks my top ADR is moving so little. Ill need to follow up with that question. Dr Mignucci stated in his report that he thought the reason was that the top ADR was too large for the space. But who can believe what he says after all this. Anyways, Im just so pleased to learn that it does have at least some movement.


He further stated that the apparent slant to my top c4/5 ADR appears due to my natural vertebral slant at that location and not due to any subsidence at that level. Of course this matches what Dr Beratagnoli told me at our meeting at DFW airport last June.

Overall he said my ADR's look good and that my current symptomology (numb forfinger and middle finger and deep dull pain around the c6/7 area) seems to match what one would expect due to a subsiding c6/7 disc. He does not believe any of my symptoms or discomfort are coming from c4/5 and c5/6 locations.

He is fully confident that fusing the c6/7 as planned will fully resolve my current discomfort and symptoms.

Lastly, he asked me how I ended up going to La Crosee, WI. I told him that was arranged through Dr B. I mentioned to him that Dr B's first choice was doing my surgery at the TX back Institute as Dr Ziglar and Dr Guyer had welcomed Dr B to do it there while they met in a conference in Vienna. But my guess is that after they got back and saw I had failed their Psyche tests, they withdrew their offer. Dr Delamarter just smiled and chuckled. It was quite clear he found that funny and bemusing. I went on to say that I guess that TBI has their studies supposedly showing that depressed patients dont have as good surgical outcomes, ....Dr Delamarter was just nodding his head side to side (in what appeared to me as disbelief or amazement) as I was talking about it. It was clear by his reaction he doesnt buy into TBI's psyche testing stuff and refusing to treat people who they think may be depressed.

Ill end in saying that I was extremely impressed with Dr Delamarter, WOW! He is so personable, and freindly and unlike some docs, is very patient in letting you ask all the questions you want. Maybe it was because he knows I came all the way from Dallas, TX , who knows. ANyways, he was the only one of the 3 docs I saw in Dallas recently who was able to show me (with a marker and ruler) exactly how much movement the top ADR was having. He made it so easy to see and understand! Why didnt the other 3 docs I saw do the same? It set me back $400 but it was so worth it to give me PEACE OF MIND in what I am moving forward with. I walked away from that meeting feeling AWESOME!! He has alot of experience, I even met 1 of his patients who was checking out at the same time I was and this guy had a 2 level ADR and 2 level fusion all at once!!

[dshobbies]

Steve,

How great for you that you're finally confident that you're making the right decision, especially given the conflicting reports you've had from I don't know how many doctors.

Okay, so listen up all you spineys - nodding of one's head refers to an up and down motion whereas shaking of one's head is side to side Isn't it great that we can take some of the stress off of Steve's neck?

Steve, have a great one! You choose.

Dale

[Maria]

Thanks for the update re your visit with Dr.Delamarter. It's good to hear he took the time to give you information that others didn't as well as reassure you and that you found him so personable (or that he was)

[steve55]

Met with Dr B and Dr Sullivan here in Wisconsin today. Apparently my disc subsided deeper into my vertebrea such that I may not have enough bone left to do a fusion with. I guess that when the disc sinks, it eats up the bone and it must just disentegrate? They may end up doing a corpectemy (removal of C5/6 & C6/7 ADR's and removal of the vertebrae). This is not quite as drastic as removing all 3 discs and two vertebraes as the dallas doctor suggested, but its still not good if that ends up being the case. Dr Sullivan said he would suggest doing the corpectemy but Dr B says that after reviewing all the films, he thinks I have just enough vertebrae left for him to be able to salvage this via fusion and save the C5/6 ADR. Dr B says that normally they dont take bone from the patient hip, they normally use donor bone. But in my case, I need the sturdiest tightest fusion possible since the vertebrae is already so compromised, so they will take bone from my hip instead. I told him I heard that the donor site pain can be worse than the fusion pain, but he says that's usally with lumbar cases due to taking much larger graphs. But with cervical, they dont need much and he will cut from the top center of the hip and not from the edges as most docs would do. This supposedly makes it much easier pain wise. He doesnt expect Ill have much of a problem with pain at the donor site (hip). I guess Ill see soon enough. Again, it may be they end up doing the corpectemy. It all depends on what they see once they have me open.

Im actually more worried about this surgery than I ever was about the 3 level ADR in germany. I have a feeling this one will really be a tough experience. Im hoping Im wrong, but Im really not looking forward to it at all. : ( Surgery is tommorrow at noon.

[Katie]

Oh Steve, what a turn of events. My prayers are with you. I don't know what else to say except good luck with it all. I have to look up all the terms to see exactly what they are doing with you as well.

Your very positive attitude has amazed me throughout all of this, and it will carry you far. I don't think I would ever have stayed as up beat as you have. You have my vote for most courageous man of the year

I just came across this now, and you will probably be being prepped for surgery as I type. I'll be checking back often to see how things are.

[dshobbies]

Steve,

Doubtful that you'll get this prior to surgery but I wish you every luck possible and hope your vertebrae is salvagable. I understand your nerves being shot and that this is a larger worry than the ADR surgery itself but you know it has to be done and is no longer a choice. In this way, it's easier.

The immediate post op pain may be severe but is also short lived. Stay on the pain pump as long as needed and you'll do fine. I look forward to your post op posts

Sending you good, good, GOOD vibes, Dale

[mmglobal]

I've been speaking to Steve for the past couple of days... he asked me to post a brief update, so here it is:

Surgery last Tuesday as planned. He got out of the hospital on Friday and is doing quite well. He's taking no pain meds and has very low pain levels. He hopes to go home on Tuesday.

Unfortunately, the findings were very unexpected. Dispite never (since the ADR surgery) presenting with any infection symptoms, labs, etc... and even his current labs being negative; it appears that the subsidence was related to infection in the bone. All 3 prostheses were removed and he has a 3 level ACDF with iliac crest autograft and anterior plate. Thankfully, they were able to get this done without removing any vertebral bodies as the Dallas surgeon had recommended.

Again... Steve is recovering nicely and I'm sure he'll be along for an update next week after he gets home and back online.

Mark